| NPI | 1912718222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MODELINE PARAISY CEO 239-456-2828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 261Q00000X Clinic/Center | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2025-01-16 |
| Last Update Date | 2026-02-11 |